Shahid Ayub, Mohammad Ilyas, Mumtaz Ali.
Surgical management of Trigeminal Neuralgia by microvascular decompression.
J Postgrad Med Inst Jan ;18(3):507-11.

Objectives: To find out the Results: of Microvascular Decompression for trigeminal Neuralgia, not responding to conservative treatment. Material and Methods: Between January 1998 and December 2001. Fifty patients underwent Microvascular decompression for trigeminal neuralgia in the Department of Neurosurgery, Hayatabad Medical Complex, Peshawar. There were 36(72%) male and 14(28%) female patients. Among them 48(96%) were unilateral cases of trigeminal neuralgia. Right side was involved in 18(36%) and left side in 32(64%). All patients underwent Microvascular Decompression. Results: During surgery, Superior Cerebellar Artery was found to be the offending vessel in 27(54%), Anterior Inferior Cerebellar Artery in 10(20%), Posterior Inferior Cerebellar Artery in 01(02%), Unnamed vessel in 04(08%), Vein in 03(06%). In 03(06%) no vascular compression could be detected during the surgery. During the follow-up period 40(80%) patients had excellent Results:. Good Results: were achieved in 06(12%) and no response in 04(08%) of patients. After surgery 04(08%) patients developed transient vomiting & vertigo, 01(02%) patient developed wound infection and 01(02%) had Cerebrospinal Fluid Leak from wound. Cerebrospinal Fluid Rinorrhoea occurred in 02(04%) patients. One patient (02%) developed permanent ipsilateral Facial nerve weakness. There was 01(02%) postoperative death. Conclusion: Trigeminal neuralgia is disease of different etiologies. Vascular compression of the trigeminal nerve roots at its entry into pons is one of the most accepted aetiology. Microvascular decompression has become one of the primary treatment of trigeminal neuralgia. We believe that in patients where medical treatment fail to respond, Microvascular decompression is the treatment of choice in trigeminal neuralgia.

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